Zielli Teresa, Gnetti Letizia, Buti Sebastiano
Medical Oncology Unit, University Hospital of Parma, Parma, Italy.
Department of Medicine and Surgery, Pathology Unit, University Hospital of Parma, Parma, Italy.
Tumori. 2020 Dec;106(6):NP79-NP83. doi: 10.1177/0300891620924472. Epub 2020 May 27.
Papillary renal cell carcinoma (pRCC) represents the second most common histologic subtype of renal cell carcinoma and comprises 2 subtypes. Prognosis for type 2 is associated with poor clinical outcome. Current guidelines are based on phase II trials, phase III trials in patients with clear cell histology, or retrospective data.
To our knowledge, we describe for the first time a case of a patient with heavily pretreated metastatic pRCC who benefited from the combination of lenvatinib plus everolimus for more than 2 years.
According to immunohistologic and biological findings in our patient both on primary tumor and liver metastasis, we hypothesize that selected patients with metastatic pRCC, progressed to standard/available treatments (including angiogenic drugs, mTOR inhibitors, and immunotherapy) and dissociated response to everolimus, could benefit from adding lenvatinib to everolimus.
乳头状肾细胞癌（pRCC）是肾细胞癌中第二常见的组织学亚型，包括2个亚型。2型的预后与不良临床结局相关。当前指南基于II期试验、透明细胞组织学患者的III期试验或回顾性数据。
据我们所知，我们首次描述了1例经过大量预处理的转移性pRCC患者，该患者从乐伐替尼联合依维莫司治疗中获益超过2年。
根据我们患者原发肿瘤和肝转移灶的免疫组织学及生物学发现，我们推测，对于转移性pRCC患者，若病情进展至标准/可用治疗（包括血管生成药物、mTOR抑制剂和免疫疗法）且对依维莫司反应不佳，加用乐伐替尼可能有益。
